Various types of cervical collars have been developed for treating conditions of the neck and cervical spine. Some of these collars are intended merely as support for whiplash and other such injuries where support for the head and neck is needed. The primary objective for the use of such a collar is to partially immobilize the head and neck, to provide support for the head, and to relieve any spasm or strain to which the neck muscles may be subjected by transmitting weight or force from the head to the shoulders or adjacent area.
Other collars are intended to be used where near complete immobilization of the head and neck are necessary. There exist presently a multitude of cervical collars intended to perform one or more of the abovementioned functions.
U.S. Pat. No. 3,572,328 to John L. Bond describes an adjustable, flexible cervical collar designed for universal use by providing vertically adjustable movable sections displaceable relative to each other and to a base portion.
U.S. Pat. No. 2,911,970 to W. L. Bartles pertains to a cervical collar having two-piece construction which allows for adjustment of the forward portion of the cervical collar. This allows for the use of a single collar by persons having different length necks, as measured in the front of the person.
U.S. Pat. No. 3,916,885 pertains to a cervical collar where the entire height of the collar is adjustable to provide a single collar for persons having different length necks.
While prior art cervical collars have had various measures of success in immobilizing the head and neck of a patient, there are several problems associated with such collars. First, there has heretofore been a trade-off between immobilizing the head and neck of a patient and patient comfort while wearing the collar. In order to increase the degree of immobilization, collars were made more rigid between the patient's chin, shoulders, sternum, and upper back. This resulted in pressure points and discomfort to the patient.
Prior art collars have not provided optimum immobilization of the patient. Attempts to provide better immobilization have heretofore met with only limited success on an extended-wear basis. Frequently, attempting to further immobilize a patient's head and neck will result in added pressure where the collar rests upon the patient's chest or supports the jaw. Further, the pressure required to immobilize a patient is generally distributed over a very small area, creating pressure points. While these pressure points are uncomfortable for the patient, they present a more serious problem in that such pressure points tend to lead over time to contraction of decubitus by the patient. Therefore, prior art collars have not been suitable for long term immobilization of a patient.
Decubitus or decubitus ulcers (also known as bed sores, pressure sores, or trophic ulcers) arise when tissues overlying a bony prominence have been subjected to prolonged pressure against an external object, in this case a cervical collar. Decubitus is basically a breakdown of the tissue overlying the bone. Decubitus ulcers can affect not only superficial tissues such as skin, but also muscle and bone. Several factors contribute to the formation of decubitus. Moisture and pressure are two of the major contributing factors to the formation of decubitus ulcers. Once a decubitus ulcer forms, the ulcer is like an iceberg, a small visible surface with an extensive unknown base. There is no good method of determining the extent of tissue damage. Once decubitus has started, it will continue to progress through the skin and fat tissue to muscle, and eventually bone. Once started, decubitus is very difficult to treat and arrest. In extreme cases, surgical replacement of bone, muscle and skin are required to restore that portion of a patient which suffers from decubitus.